Endoscopic endonasal transsphenoidal surgery in children: Necker - Enfants Malades Hospital experience.

OBJECTIVE

This study aimed to analyze a large series of children treated transsphenoidally by both neurosurgical and Ear Nose Throat (ENT) surgical teams for sellar or parasellar lesions.

STUDY

DESIGN

It was an observational study in a French pediatric tertiary referral center.

SETTING

The patients included were under 18 years of age at time of surgery, had no open neurosurgical history, and required endoscopic endonasal transsphenoidal surgery.

METHODS

All endoscopic endonasal procedures were conducted by both neurosurgeon and ENT surgeon alternating as first operator according to the different phases of the operation. Data collection was carried out using the Dr Warehouse data platform.

RESULTS

From 2005 to 2018, 75 children (41 boys and 34 girls) were included retrospectively. The average age at the time of surgery was 10 years [range: 3-17]. One hundred twenty-three procedures were performed: 75 primary tumour resections (17 partial (22.7 %), 35 (46.7 %) near total and 18 (24 %) total resections), 5 biopsies, 45 revision procedures for tumour recurrences or residuals and 3 revision procedures for post-operative cerebrospinal fluid (CSF) leaks. 10 patients (13.3 %) had post-operative CSF leaks and 5 patients (6.7 %) developed meningitis without any sequelae. No death occurred.

CONCLUSION

The minimally invasive transsphenoidal endonasal surgery is feasible in the pediatric population, allows excision of sellar and parasellar lesions in children without major complications, and avoids open technique comorbidities.